It's time to rethink our approach to respiratory illnesses.
For many, the pre-pandemic times seem like a blur! While the vast majority have tried to go back to living a “normal life”, the impact of the pandemic and its sequelae are still everywhere to be seen: from the small but visible minority who still mask up as a precaution, to the ubiquitous presence of hand sanitizers, and the fading signs and posters that are still present in various public spaces, reminding us to keep our distance from each other and comply to other pandemic-era mitigation measures.
However, one memory of the pre-pandemic times that is now coming back to many of us (as society has opened up again) is the widespread levels of viral respiratory infections making us ill. Before COVID-19, we took it as a fact of life that we would get sick with “colds” at least a few times a year. For those with school aged children, it was not uncommon to experience a viral illness every other week, as their kids became incubators of all sorts of viruses and spread them around freely at school or other settings.
Indeed, viral respiratory infections have long been a part of human existence, but their dangers and consequences have become all too evident in recent times. The world witnessed the devastating effects of the COVID-19 pandemic, which underscored the significant societal and economic impacts of allowing viruses to spread unchecked. However, even before the emergence of COVID-19, viral respiratory infections had a substantial impact on productivity, income, and public health.
The Economic Toll
Long before COVID-19 brought the world to a standstill, viral respiratory infections were exacting a significant economic toll on societies worldwide. Influenza, the common cold, and other respiratory viruses have been responsible for countless missed workdays and reduced productivity. In the United States alone, the flu was estimated to cost approximately $10.4 billion annually in direct medical expenses, and $87.1 billion in total economic burden (such as lost productivity) in 2003.
Employees who fall ill due to viral respiratory infections often require time off work, resulting in a reduction in output and income. This not only affects individual workers but also has a cascading effect on businesses and the broader economy. Moreover, employees who come to work while infected risk spreading the virus to their colleagues, further perpetuating the cycle of illness and economic loss. The same is true for working parents when their children contract a viral respiratory infection.
The COVID-19 Wake-Up Call
COVID-19 was a stark reminder of the dangers of allowing viral respiratory infections to spread unchecked. The pandemic exposed the vulnerabilities of healthcare systems and the inadequacies in global pandemic preparedness. Millions of lives were lost, and economies were pushed to the brink of collapse as countries scrambled to control the spread of the virus.
Beyond the immediate health crisis, COVID-19 disrupted supply chains, shuttered businesses, and led to widespread job losses. The economic consequences of the pandemic were profound, with many individuals and families experiencing financial hardship. Governments around the world implemented unprecedented measures to mitigate the economic fallout, but the damage was already done. The world is still grappling with the economic and health effects of COVID-19 to this day.
Broader Health Impacts
Allowing viral respiratory infections (COVID-19, the common cold or influenza) to spread unchecked has health consequences that extend beyond the initial illness. Many viral infections can lead to complications and, in some cases, trigger the development of chronic conditions. For instance, respiratory viruses like influenza can lead to pneumonia, exacerbate pre-existing lung conditions, and increase the risk of hospitalization or death.
Furthermore, there is evidence to suggest that viral respiratory infections may be linked to the development of autoimmune disorders. Research has shown that certain viruses may trigger an abnormal immune response, potentially leading to autoimmune diseases like rheumatoid arthritis or multiple sclerosis. While the exact mechanisms behind these connections are complex and still being studied, they underscore the far-reaching health impact of viral infections.
Mitigation Measures for a Healthier and More Prosperous Society
In light of the economic and health burdens associated with viral respiratory infections, it is crucial that societies adopt effective mitigation measures. These measures should not be limited to COVID-19 but should encompass a broader approach to prevent and control viral infections during respiratory illness seasons. Some key strategies include:
Vaccination: Widespread vaccination programs have proven effective in reducing the spread and severity of many viral respiratory infections, including influenza and COVID-19. Encouraging vaccination among all eligible individuals can help create a protective barrier against these viruses. We should also support the development of new vaccines against other respiratory viruses, such as RSV or the common cold pathogens.
Hygiene and Social Distancing: Promoting proper hygiene practices, such as handwashing and respiratory etiquette, can reduce the transmission of viruses. Additionally, social distancing measures, or limiting indoor capacity during the respiratory season, can help limit the spread of infections in crowded settings. Finally, as a society we should re-visit our discriminatory attitudes and antipathy towards masking practices and acknowledge that use of high quality masks can be an important tool in fighting the annual epidemic of viral respiratory illnesses.
Clean Air: Thanks to COVID-19, we now know much more about how viral particles are transmitted through the air, and this understanding has allowed us to question the longstanding dogma that the medical establishment has held for decades about aerosol transmission. The importance of ensuring that the air we share with each other is clean should go beyond our historical focus on outdoor air pollution, and must include indoor air quality and its relation to viral illness transmission.
Enhanced Healthcare Infrastructure: Strengthening healthcare systems is essential to managing the burden of viral respiratory infections effectively. This includes adequate testing, contact tracing, and resources for patient care. Development of rapid antigen tests for other viral infections - such as influenza - should be a priority, as early detection can lead to deployment of antivirals that have been shown to reduce morbidity and mortality. Adoption of technology to augment contact tracing is another area that should be explored. COVID-19 has shown us that it is only a matter of time before the next pandemic emerges, and that our healthcare systems are woefully unprepared for it.
Public Awareness and Education: Educating the public about the risks of viral respiratory infections and the importance of preventive measures is vital. Public health campaigns can help raise awareness and encourage responsible behavior. Perhaps the most dangerous outcome from COVID-19 has been the general loss of faith in public health institutions, as evidenced by the rise of “anti-vaxxers” on one hand, and the emergence of advocacy voices who criticise public health for being too hesitant to take action and prone to political influence. Restoring faith in public health should be a high priority for medical and political leaders, if we are to be prepared to address future pandemic challenges.
Remote Work and Flexible Policies: Employers can implement flexible work arrangements that allow employees to work from home when they are unwell, reducing the risk of viral transmission in the workplace. The idea that a person should come to work even if they are feeling unwell should be erased once and for all, and government policies must support both workers and employers to allow for that.
Conclusions
The dangers of allowing widespread dissemination of viral respiratory infections have been underscored by the COVID-19 pandemic, but the economic and health consequences were evident long before its emergence. Viral infections have the power to disrupt economies, affect individual income, and lead to serious health complications, including autoimmune disorders.
One lesson that I hope we can learn from our experiences over the past few years is that as a society, we can (and indeed must) take proactive measures to mitigate the spread of viral respiratory infections, and rethink our historical view that many of these illnesses are “mild” and we should simply learn to live with them. By collectively adopting such measures, we can reduce the economic and health burdens of viral respiratory infections. It is our responsibility to protect our communities, our economies, and our well-being in the face of these invisible threats.